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. 2022 Mar 2:14:100-104.
doi: 10.1016/j.artd.2022.01.026. eCollection 2022 Apr.

Consistency of Acetabular Height in Sequential Bilateral Total Hip Arthroplasty

Qingwu Kong  1 , Walaa Abdelfadeel  1 , Rock Hwang  1 , Arjun Saxena  1 , Andrew Star  1
Affiliations

Consistency of Acetabular Height in Sequential Bilateral Total Hip Arthroplasty

Qingwu Kong et al. Arthroplast Today. .

Abstract

Background: Achieving appropriate leg length after surgery remains a concern for surgeons performing total hip arthroplasty (THA). The focus of surgeons trying to equalize leg length has been primarily on positioning of the femoral implant. This study evaluates the impact of acetabular height on leg length and its impact on femoral component choices during THA.

Methods: We reviewed standing pelvic radiographs of 100 patients who underwent staged bilateral THA by a single surgeon from 2016 to 2019. Leg length discrepancies and acetabular heights were determined from preoperative and postoperative radiographs. The difference between the first and second operative hips was compared at each stage of the procedures. Results were analyzed using paired t-tests.

Results: There is a significant increase in mean leg length and acetabular height after both the first and second stages of the procedure. Although there was a small change in average acetabular height for each procedure, height increased or decreased by greater than 5 mm in 44 of 200 cases. Comparing left to right hips after the second surgery disclosed no statistically significant differences in acetabular height or leg length.

Conclusion: Acetabular height and leg length changes with each stage of the procedure in sequential bilateral THA. In almost 25% of cases, the acetabular height changed by more than 5 mm. This has significant implications and needs to be considered during preoperative planning as well as operative decision-making. To account for these differences, a THA may require intraoperative acetabular assessment and changes in femoral positioning and sizing to achieve the optimal leg length.

Keywords: Acetabular height; Femoral component; Limb length discrepancy; Total hip arthroplasty.

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Figures

Figure 1
Figure 1
The leg lengths are measured from the interteardrop line to the most prominent aspect of the lesser trochanter. In this patient, the postoperative right lower extremity is longer than the left lower extremity.
Figure 2
Figure 2
The acetabular height is measured from the interteardrop line to the acetabular center of rotation. In this patient, the acetabular height for the right hip is 13 mm, while the acetabular height for the left hip is 12 mm.
Figure 3
Figure 3
Acetabular height after the first THA. Scatter plot of first operative limb (postoperative) vs second operative limb (preoperative).
Figure 4
Figure 4
Differences in acetabular height between first operative limb (postoperative) and second operative limb (preoperative) after the first THA.
Figure 5
Figure 5
Scatter plot of acetabular height of first operative limb. Before and after the first THA (postoperative).
Figure 6
Figure 6
Scatter plot of acetabular height of second operative limb. Before the first THA (preoperative) and after the second THA (postoperative).
See this image and copyright information in PMC

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